Red cell distribution width is a predictor of mortality in patients undergoing percutaneous coronary intervention

被引:58
作者
Fatemi, Omid [1 ]
Paranilam, Jaya [2 ]
Rainow, Alex [3 ]
Kennedy, Kevin [4 ]
Choi, Jason [5 ]
Cutlip, Donald [5 ,6 ]
Pencina, Michael [6 ,7 ]
Berger, Peter B. [8 ]
Cohen, David J. [4 ]
Kleiman, Neal S. [2 ]
机构
[1] Washington Hosp Ctr, Washington, DC 20010 USA
[2] Methodist DeBakey Heart & Vasc Ctr, Houston, TX USA
[3] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA
[4] St Lukes Mid Amer Heart Inst, Kansas City, MO USA
[5] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[6] Harvard Clin Res Inst, Boston, MA USA
[7] Boston Univ, Sch Publ Hlth, Boston, MA USA
[8] Weis Ctr Res, Geisinger Clin, Danville, PA 17822 USA
关键词
RDW; PCI; Stent; EVENT; HEART-FAILURE; PROGNOSTIC MARKER; RISK; ERYTHROCYTE; DISEASE; RECLASSIFICATION; THROMBOPOIESIS; CHOLESTEROL; OUTCOMES; COHORT;
D O I
10.1007/s11239-012-0767-x
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Red cell distribution width (RDW), a measure of the variability in size of circulating erythrocytes, is an independent predictor of mortality in patients with cardiovascular disease. We hypothesized that RDW is a prognostic marker of death, myocardial infarction and unplanned revascularization in a broad population undergoing percutaneous coronary intervention (PCI). We investigated the prognostic value of RDW derived from a complete blood count drawn a parts per thousand currency sign24 h of PCI in 1,689 patients at four centers who underwent PCI between 2004 and 2007 in the evaluation of drug eluting stents and ischemic events registry. Patients who underwent blood transfusions were excluded. Multivariable analyses of death, MI, unplanned revascularization, and the combined occurrence of these events at 1 year were performed using methods from survival analysis. The analysis was adjusted for creatinine a parts per thousand yen1.5 mg/dL, hemoglobin, congestive heart failure, coronary artery bypass grafting history, male sex, BMI, atherosclerosis of a parts per thousand yen2 coronary vessels, and hypertension. In univariate analysis of RDW stratified by quartiles, membership in the highest quartile was a predictor of mortality as compared to the lowest quartile (HR 5.07, CI 2.07-12.40, p < 0.001). In multivariate analysis, RDW was not an independent predictor of unplanned revascularization after PCI; however, RDW remained an independent correlate of 1 year mortality (HR 1.65, CI 1.22-2.23, p = 0.001); with a continuous net reclassification improvement of 46.5 % (95 % CI 15.1-76.4 %) and a relative integrated discrimination improvement of 57.8 % (95 % CI 22.1-94.9 %) after PCI. RDW is a widely available independent correlate of 1-year mortality after PCI that increases the discriminative value of risk prediction in these patients.
引用
收藏
页码:57 / 64
页数:8
相关论文
共 30 条
[1]
Validation and Potential Mechanisms of Red Cell Distribution Width as a Prognostic Marker in Heart Failure [J].
Allen, Larry A. ;
Felker, G. Michael ;
Mehra, Mandeep R. ;
Chiong, Jun R. ;
Dunlap, Stephanie H. ;
Ghali, Jalal K. ;
Lenihan, Daniel J. ;
Oren, Ron M. ;
Wagoner, Lynne E. ;
Schwartz, Todd A. ;
Adams, Kirkwood F., Jr. .
JOURNAL OF CARDIAC FAILURE, 2010, 16 (03) :230-238
[2]
Elevated red blood cell distribution width predicts mortality in persons with known stroke [J].
Ani, Chizobam ;
Ovbiagele, Bruce .
JOURNAL OF THE NEUROLOGICAL SCIENCES, 2009, 277 (1-2) :103-108
[3]
Total erythrocyte membrane cholesterol - An innocent new marker or an active player in acute coronary syndromes? [J].
Arbustini, Eloisa .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (21) :2090-2092
[4]
Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography [J].
Cavusoglu, Erdal ;
Chopra, Vineet ;
Gupta, Amit ;
Battala, Venkata R. ;
Poludasu, Shyam ;
Eng, Calvin ;
Marmur, Jonathan D. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2010, 141 (02) :141-146
[5]
A WILCOXON-TYPE TEST FOR TREND [J].
CUZICK, J .
STATISTICS IN MEDICINE, 1985, 4 (01) :87-90
[6]
Relation Between Red Cell Distribution Width and Clinical Outcomes After Acute Myocardial Infarction [J].
Dabbah, Saleem ;
Hammerman, Haim ;
Markiewicz, Walter ;
Aronson, Doron .
AMERICAN JOURNAL OF CARDIOLOGY, 2010, 105 (03) :312-317
[7]
STIMULATION OF MEGAKARYOCYTOPOIESIS AND THROMBOPOIESIS BY THE C-MPL LIGAND [J].
DESAUVAGE, FJ ;
HASS, PE ;
SPENCER, SD ;
MALLOY, BE ;
GURNEY, AL ;
SPENCER, SA ;
DARBONNE, WC ;
HENZEL, WJ ;
WONG, SC ;
KUANG, WJ ;
OLES, KJ ;
HULTGREN, B ;
SOLBERG, LA ;
GOEDDEL, DV ;
EATON, DL .
NATURE, 1994, 369 (6481) :533-538
[8]
Red cell distribution width as a novel prognostic marker in heart failure - Data from the CHARM program and the Duke Databank [J].
Felker, G. Michael ;
Allen, Larry A. ;
Pocock, Stuart J. ;
Shaw, Linda K. ;
McMurray, John J. V. ;
Pfeffer, Marc A. ;
Swedberg, Karl ;
Wang, Duolao ;
Yusuf, Salim ;
Michelson, Eric L. ;
Granger, Christopher B. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (01) :40-47
[9]
Red cell distribution width in heart failure: Prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state [J].
Forhecz, Zsolt ;
Gombos, Timea ;
Borgulya, Gabor ;
Pozsonyi, Zoltan ;
Prohaszka, Zoltan ;
Janoskuti, Livia .
AMERICAN HEART JOURNAL, 2009, 158 (04) :659-666
[10]
Oxidative stress in the regulation of normal and neoplastic hematopoiesis [J].
Ghaffari, Saghi .
ANTIOXIDANTS & REDOX SIGNALING, 2008, 10 (11) :1923-1940